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[A case of Schneiderian middle-ear and sinonasal papilloma with intracranial complications]
Masaya Uchida1, Tomoki Fujita, Kohtaro Okamoto
1Department of Otolaryngology, Kyoto Second Red Cross Hospital, Kyoto.
Abstract:
Unlike Schneiderian papilloma, a widespread benign epithelial neoplasm arising in the sinonasal tract mucosa of the nasal cavity, paranasal sinus, trachea, and larynx, middle-ear Schneiderian papilloma is extremely rare. We report a case of recurrent Schneiderian papilloma spreading to the bilateral middle ear and right paranasal sinus, and eventually causing cerebellar complications. A-52-year old woman seen for episodes of inarticulateness was first, found to have middle right ear and right ethmoid papilloma, that occurred thereafter is the middle left ear. This bilateral middle-ear papilloma is, to our knowledge, the only case reported thus far, and fell into a low-risk malignant formation group based on HPV-DNA testing. Given previous cases, we concluded that ours warranted meticulous follow-up because recurrence and malignancy are more common in multiple-site middle-ear papilloma as in our case rather than papilloma of the middle ear alone.
Insights
Middle-ear Schneiderian papilloma is rare, but this case shows bilateral spread causing cerebellar issues. Multiple-site papillomas require close monitoring due to higher recurrence and malignancy risks.
Area of Science:
- Otolaryngology
- Neurosurgery
- Oncology
Background:
- Schneiderian papilloma typically affects the sinonasal tract.
- Middle-ear Schneiderian papilloma is exceptionally rare.
Observation:
- A 52-year-old woman presented with inarticulateness and bilateral middle ear papilloma.
- The papilloma also spread to the right paranasal sinus, leading to cerebellar complications.
- HPV-DNA testing classified the tumor as low-risk malignant formation.
Findings:
- This is the only reported case of bilateral middle-ear Schneiderian papilloma.
- Recurrence and potential malignancy are more common in multiple-site papillomas.
Implications:
- Meticulous follow-up is crucial for patients with multiple-site middle-ear papilloma.
- This case highlights the aggressive potential and rare presentation of Schneiderian papilloma.
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